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Individual

BRIDGETT VICENTA LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10400 BLACKLICK EASTERN RD, PICKERINGTON, OH 43147-8235
(419) 575-2196
Mailing address
7081 QUAIL LAKES DR, HOLLAND, OH 43528-9390
(419) 575-2196

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0487170
OH
Enumeration date
05/23/2025
Last updated
05/23/2025
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